Provider Demographics
NPI:1912003740
Name:ALAN L BIDDINGER MD PHD PC
Entity Type:Organization
Organization Name:ALAN L BIDDINGER MD PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BIDDINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD
Authorized Official - Phone:248-828-1100
Mailing Address - Street 1:6905 ROCHESTER RD
Mailing Address - Street 2:STE B
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-1282
Mailing Address - Country:US
Mailing Address - Phone:248-828-1100
Mailing Address - Fax:248-828-1101
Practice Address - Street 1:6905 ROCHESTER RD
Practice Address - Street 2:STE B
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-1282
Practice Address - Country:US
Practice Address - Phone:248-828-1100
Practice Address - Fax:248-828-1101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301070667207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F39103OtherBCBS
MIH65302Medicare UPIN
MI5763290001Medicare NSC
MI0P21020Medicare PIN